A Predictive Scale for Dehiscence of the Intestinal Suture Line

Abstract

Introduction: The suture line dehiscence is one of the most frequent complications in intestinal surgery.

Objective: To design a predictive scale for estimating individual probability of suture line dehiscence.

Methods: An analytical cohort study, which involved retrospective data collection, was carried out, in the six-year period of 2014-2019, at Celia Sánchez Manduley Hospital. The sample consisted of 437 patients. Dehiscence of the intestinal suture line was used as a dependent variable, while age, sex, comorbidity, hemoglobin, hypoalbuminemia, colon neoplasia, anesthetic risk, among others, were used as independent variables.

Results: Through multivariate analysis, an adjusted model was obtained, with the following results for the variables: age over 70 years (P=0.002), hypoalbuminemia (P=0.014), enterocolic anastomosis (P=0.018), urgent surgery (P=0.001), and ileus prolonged paralytic (P<0.001). The predictive scale was derived from the adjusted statistical model and, based on the probability of dehiscence of the intestinal suture line, classified into three risk groups: low (less than two points), moderate (between 3-5 points) and high (more than six points). It presented a sensitivity of 89.6%, a specificity of 89.1%, a global predictive percentage of 89.2%, a positive predictive value of 66.1%, and a negative predictive value of 97.2%. It had an excellent calibration and a high discriminative power.

Conclusion: A predictive scale was obtained for estimating the individual probability of dehiscence of the intestinal suture line.

Keywords: dehiscence; intestinal suture; predictive scale.